Bronchogenic sarcomatoid squamous cell carcinoma with osteoclast-like giant cells

A 60-year-old man developed a widely metastatic spindle cell neoplasm with admixed osteoclast-like giant cells indistinguishable from malignant giant cell tumor of soft parts. Autopsy revealed a bronchogenic sarcomatoid squamous cell carcinoma that was the primary source of the sarcomatoid metastases. The osteoclast-like giant cells in the metastatic lesions were negative for lysozyme on immunoperoxidase staining. This finding suggested that the multinucleated giant cells were not formed as a cellular response to hemorrhage or to cellular debris induced by the tumor. Extraosseous neoplasms with osteoclast-like giant cells are rare neoplasms that may occur in a variety of organs. This case is the second reported case of a primary neoplasm in the lung that contained these osteoclast-like giant cells. These tumors may cause considerable diagnostic confusion.     

Tubular metaplasia in Bowman''s capsule

Proximal tubular type metaplasia of the epithelium of Bowman's capsule is described in a fit young adult male. This form of metaplasia is unlike those previously described and could cause initial confusion if encountered in a percutaneous renal biopsy.     

Histopathological characteristics of metastasizing squamous cell carcinoma of the skin and lips

AIMS: The reported incidence of metastasis from squamous cell carcinoma (SCC) of the skin and lip varies between 0.5% and 16%. Clinical and histopathological criteria have been proposed to identify tumours that may have an increased risk of metastasis. The aim of this study was to define such high-risk tumours, especially since the incidence of SCC of the skin is increasing. METHODS AND RESULTS: Histopathological features of metastasized skin and lip tumours and a matched group of non-metastasizing tumours were reassessed. Characteristics studied were: tumour width, excision margins, histological subtype, Clark level, Breslow depth, tumour differentiation, inflammation, perineural and angio-invasive growth, ulceration and desmoplasia. Data were statistically analysed separately for skin and labial lesions. Desmoplasia, Clark level, Breslow depth, maximum diameter, angio-invasion, grading, perineural invasion, plasma cells and eosinophilic inflammatory response proved to be statistically significantly related to metastasis of skin tumours. Breslow depth, plasma cells and grading appeared to be statistically significantly related to metastasis of SCC of the lips. CONCLUSIONS: A typical metastatic SCC showed: a tumour width of at least 15 mm, a vertical tumour thickness (=Breslow) of at least 2 mm, less differentiation, presence of desmoplasia and an inflammatory response with eosinophils and plasma cells.     

Bronchogenic carcinoma of squamous cells in a young pregnant woman

Lung cancer continues to be the most incident neoplasia in the world and also the most frequent cause of death by cancer, with more than 900000 new cases per year. Women present greater risk of developing bronchogenic carcinoma, possibly because of differences in metabolism of the carcinogens associated with tobacco and also because of hormonal differences because estrogens can promote the appearance of lung cancer, including during pregnancy. We have described the case of a 25-year-old patient who developed squamous cell carcinoma of the lung during her third pregnancy, with a progressive worsening of her general condition and progression until death. We believe that the pregnancy could have contributed to the evolution of the disease, especially because of the increased levels of gestational hormones, particularly the estrogen, because its receptors have an important role in regulating growth and in the differentiation of several tissues facilitating like this, the development of the neoplasia, and complicating its early diagnosis.     

Bronchogenic squamous cell carcinomas with invasion along alveolar walls

In bronchogenic squamous cell carcinoma, a growth pattern along the alveolar walls of the peripheral lung parenchyma is unusual. In order better to understand the way tumour cells invade the peripheral lung parenchyma, we studied two cases of squamous cell carcinoma with invasion along the alveolar walls (in 30% to 40% of the area surrounding the tumour). We used immunohistochemical staining with antibodies against pulmonary surfactant, apoproteins (PE-10) and collagen type IV, and electron microscopy. Tumour cells invading the peripheral lung tissue were located between one layer of type II alveolar epithelial cells and the basement membrane of the alveolar walls. These results suggest that the cells of a squamous carcinoma (unlike an adenocarcinoma) have the ability to spread along the basement membrane of the alveolar walls without destroying pre-existing normal peripheral lung parenchyma.     

Merkel cell carcinoma metastasizing to the kidney mimicking primary neuroendocrine renal cancer

A 56-year-old male with a history of cutaneous neuroendocrine (Merkel cell) carcinoma presented with a solid mass of the left kidney, measuring 10 cm in largest diameter. On histology, the tumour was composed of loosely packed uniform cells with round-to-oval nuclei and scant cytoplasm. Immunohistochemically, the tumour cells diffusely expressed pancytokeratin and neuroendocrine markers, such as chromogranin A, synaptophysin and CD56 (NCAM). Distinct paranuclear dot-like expression of cytokeratin 20 showed the lesion to be metastatic Merkel cell carcinoma. This is the first reported case of Merkel cell carcinoma metastatic to the kidney mimicking primary neuroendocrine renal cancer. We discuss the differential diagnosis of the tumour and perform a systematic literature review, including potential indications for renal tumour biopsy in patients with a history of nonrenal malignancy.     

Signet-ring squamous cell carcinoma

Among carcinomas, signet-ring morphologic characteristics have been regarded as pathognomonic of adenocarcinoma. This report presents the case of a poorly differentiated cutaneous squamous cell carcinoma with a monodispersed, invasive signet-ring component. Kreyberg stains had negative results for mucin. Immunohistochemical analysis demonstrated that concentric rings in the signet-ring cells were composed of keratin. To the best of the authors' knowledge, this is the first report of signet-ring squamous cell carcinoma. Another feature that bears emphasis is that this squamous cell carcinoma led to the death of the patient, even though it originated in a field of actinic keratosis.     

Papillary endobronchial squamous cell carcinoma

A case of papillary endobronchial squamous cell carcinoma incidentally discovered on routine imaging studies is described. The patient, a 75-year-old woman, underwent imaging studies as part of a standard evaluation for a fracture on the right side of the hip. Chest radiographs were unremarkable other than for a nodular opacity overlying the left hemidiaphragm. Computed tomography of the chest, however, demonstrated an elongated, irregular mass in the right lower lobe that appeared to be associated with an adjacent segmental right lower lobe bronchus. Endoscopy followed by surgical resection was undertaken, revealing a tan, soft mass measuring 1.5 x 1.3 x 0.8 cm that was confined to the bronchus and did not appear to extend into the surrounding lung parenchyma. Microscopically, the mass showed a papillary, superficial squamous cell carcinoma confined to the bronchial mucosa without invasion of adjacent structures. The pathological and imaging features of this unusual variant of bronchogenic carcinoma are reviewed as well as the radiological differential diagnosis of endobronchial lesions. To our knowledge, this is the first report that describes the computed tomographic features of this rare lesion.     

Papovavirus and squamous cell carcinoma

There is considerable interest in the role of the human wart virus in the pathogenesis of squamous cell carcinoma. Mucosal wart virus infections may produce considerable epithelial atypia and have eventuated in carcinoma in "normal" individuals in some instances. The verruciform lesions of patients with epidermodysplasia verruciformis frequently have this outcome. The finding of a virus of papova morphology in the noncondylomatous epithelium adjacent to a squamous cell carcinoma of the tongue in a young immunosuppressed patient is described. Such a finding adds credibility to the belief that a virus of the papova group may be integral to neoplastic evolution in at least some instances.     

Pigmented cutaneous squamous cell carcinoma

Squamous cell carcinoma is an extremely common cutaneous neoplasm, with an incidence second only to basal cell carcinoma and steadily rising, and specimens regularly crossing the reporting pathologist’s bench. Cutaneous pigmented squamous cell carcinoma is a relatively uncommon and perhaps under-recognized pathological variant of squamous cell carcinoma. Florid examples causing clinically evident pigmented lesions are quite rare, with less than 30 cases of cutaneous pigmented squamous cell carcinoma reported in the English literature to date. The pathophysiology of this entity is unknown, and literature addressing this is limited. The diagnosis of cutaneous pigmented squamous cell carcinoma is an important one, as it may be a source of confusion for both clinicians and pathologists because it can be mistaken for other entities including malignant melanoma. In this paper we report a case of cutaneous pigmented squamous cell carcinoma and discuss its clinical and histopathologic features, underlying pathophysiology and important differential diagnoses.     

子宫颈、食管鳞状细胞癌人乳头状瘤病毒感染的比较研究

目的 探讨同一地区人乳头瘤病毒在宫颈鳞状细胞癌的感染特征及与食管鳞状细胞癌的关系.方法 采用PCR技术和快速导流杂交基因芯片技术分别对来自河南同一地区的75例宫颈鳞癌患者和78例食管鳞癌患者进行HPV 分型检测.结果 来自同一地区的宫颈、食管鳞癌组织中,HPV16型阳性检出率均最高,分别为83%(58/70)和82%(49/60),其余阳性类型宫颈鳞癌中依次为HPV58、18、31、6、52、33、11,分别占14%(10/70),9%(6/70),7%(5/70),6%(4/70),6%(4/70),4%(3/70),4%(3/70);食管鳞癌中依次为HPV18、58、31、6、11,分别占15%(9/60),8%(5/60),7%(4/60),5%(3/60),5%(3/60).对HPV16阳性的宫颈、食管鳞癌标本DNA进行HPV16致癌基因E6/E7扩增进行验证,阳性率为100%.结论 同一地区居民宫颈(食管)鳞癌HPV感染亚型相似,提示HPV可能是这两种肿瘤的共同致病因素,HPV16可能在宫颈和食管癌变过程中起重要作用,也为其生物防治提供了重要理论依据.     

Adenoid squamous cell carcinoma of the larynx: an uncommon histological variant of squamous cell carcinoma

Adenoid squamous cell carcinoma (ASCC) or acantholytic squamous cell carcinoma is a well-recognized variant of squamous cell carcinoma. ASCC commonly occurs in the sun-exposed areas of the skin and has only rarely been observed in mucosal sites. We report a case of ASCC in the larynx of a 75-year-old man with a history of odynophagia and dysphonia of 3 months' duration that presented as an exophytic lesion on the right vocal cord. Biopsy was performed and the histological diagnosis was squamous cell carcinoma. Treatment consisted of total laryngectomy and radical neck dissection. Microscopically, the tumor showed a prominent alveolar pattern with cystic degeneration of the neoplastic epithelium and formation of pseudoglandular structures. In the lumina there were acantholytic cells. Transition areas from conventional squamous cell carcinoma to adenoid pattern were found. To the best of our knowledge this is only the third case of ASCC reported in the larynx. We reviewed the nine mucosal ASCCs of the upper aerodigestive tract reported. The assertion that these tumors are associated with an aggressive behavior and poor prognosis cannot be estimated in this review as the number of cases is small and the tumors are located in different places.     

Morphometric grading of squamous cell carcinoma

Histological grading of squamous cell carcinoma is subjective and suffers from poor observer reproducibility. We investigated the feasibility of quantifying histological differentiation via point counting, using both the degree of keratinization and a novel definition of differentiation that was based on architectural features of the tumour. Multiple recounts of 20 cases of human oral squamous cell carcinoma were performed at several magnifications (X100, X160 and X250). Six lines of human squamous cell carcinoma tumour lines were examined for changes in differentiation following transplantation to athymic nude mice. Observer reproducibility was extremely high for all recounts except at the highest magnification, where the tumour architecture may have been obscured. Of the human squamous cell carcinomas transplanted to nude mice, five of six tumour lines showed significant histological changes, most commonly toward decreased differentiation. The changes were usually present in the initial transplant and were similar to those we have reported for transplants of adenocarcinomas. We conclude that histological differentiation can be quantified in squamous cell carcinomas with a high degree of observer reproducibility, even in the absence of keratinization; the method employed is sufficiently sensitive to be applied to practical problems of biological significance.     

含有鳞状细胞癌成分的乳腺化生性癌临床病理特征

目的探讨含有鳞状细胞癌成分的乳腺化生性癌(metaplastic carcinoma with squamous cell component,MCSC)的临床病理特征和免疫表型特点。方法复习20例MCSC的临床病理资料,总结其巨检、组织学、免疫表型和预后特点。结果本组肿瘤中纯鳞状细胞癌(squamous cell carcinoma,SCC)6例、腺鳞癌(adenosquamous carcinoma,ASC)13例、癌肉瘤1例。全组平均发病年龄52·4岁,多表现为无痛性乳腺肿块。SCC和ASC腋淋巴结转移率分别为60%和66·7%。巨检45%病例呈囊性。镜下角化型SCC2例、棘层松解型1例、角化与棘层松解混合型2例、角化与梭形细胞混合型1例。ASC中的SCC成分均为角化型,腺癌成分则为浸润性导管癌,仅1例混有少量黏液癌。1例癌肉瘤含有鳞癌、腺癌和软骨肉瘤成分。进行免疫组化染色病例的SCC成分均呈CK34βE12、CK5/6、CK14和p63阳性,ER、PR阴性。5例腺癌成分呈CK34βE12灶性阳性,各有1例腺癌成分灶性表达CK14和CK5/6。CK8阳性见于所有腺癌成分,仅1例SCC成分呈灶性阳性。SMA在本组肿瘤的腺鳞两种成分均呈阴性。结论MCSC以ASC最为常见,眼观呈囊性是其特点之一。SCC成分的组织学类型和分化程度存在不同程度变异。CK14、p63和CK8作为一种组合可能有助于SCC的鉴别诊断。规范诊断标准的大样本研究将会提供更有价值的临床病理资料。     

Acid phosphatase in squamous cell carcinoma

Surgical specimens of oral squamous cell carcinoma were processed for cytochemistry of acid phosphatase using Gomori's substrate. Reaction product was deposited in the cytoplasmic dense bodies, autophagic vacuoles, cytoplasmic projections, and advancing cell borders. Results of this study suggest that acid phosphatase and its associated lysosomes seem to play a role in the invasiveness of cancer cells.     

宫颈微小浸润性鳞状细胞癌

宫颈微小浸润癌（microinvasive cervical cancer,MIC）的概念提出已经有100多年了,对于其病理诊断标准及临床治疗方法一直存在争议,但随着对其研究的广泛深入,特别是对微小浸润性鳞状细胞癌的研究,所涉及的样本量比较大,随访时间充分,得到了一些有意义的研究成果。相比较而言,对于宫颈微小浸润性腺癌的研究还不够全面,我们仅就近十几年来对于宫颈微小浸润鳞状细胞癌的研究及探讨进行概述,以供病理和临床医生参考。